Treatment Resistant Depression

[Cleo1011]

Hi, I've got TRD. I have okay days, and then really really bad days. I'm just a hot mess that makes it through the work day with a fake smile on my face, then comes home exhausted from "pretending", and sad from loneliness.

I joined here, hoping to find a friend to chat with on a regular basis. Just to listen, share, empathize, support, commiserate, blah blah.

I'm trying out Spravato (ie: estketamine). Not sure if its working. I'm also trying psychotherapy, not sure if thats working either. I went thru multiple CBT therapists that did not help.

Thanks for reading, hope to connect with someone,

Cheers,

Cleo

[Focusedmind]

Welcome to the community. We are here to listen and support you! I have used psychotherapy for many years and found it worked for me, but I know everyone is different. This community is filled with people who have tried various therapies, so you have come to the right place to ask questions. So, ask away!

[Cleo1011 in reply to Focusedmind]

Hi, thanks for replying. psychotherapy, as in the Freudian "talk therapy"? How often did you go? do you still go? My therapist expects me to do all the talking, and I am not a talker. I feel that I'm just sitting there, complaining, blabbing, re-living my angst.

[Focusedmind in reply to Cleo1011]

I have had different counselors over the years. Some expect me to do all the talking while they listen; others are more interactive, ask questions, and offer solutions. I think I am like you in that I prefer the latter. The counselor I have now does this, which I find helpful. I make a list of things to discuss before going into sessions, add items to this list while talking with her, and address the list on the next visit. This method keeps me more focused and less likely to get sidetracked with emotions.

Also, other members on this site suggested doing a DNA test to see what medicines are compatible with your genetics. There was the suggestion of using a company called Genesight, a lab that does this analysis. Perhaps this might help you find some medication that would do a better job of helping your depression. I know genetics plays a big role in my family's mental health.

[Cleo1011 in reply to Focusedmind]

Hi, I did do a DNA/genetic test years ago to see what meds were best compatible with my biology. Prozac was the match; which I was already on for a good 12ish years. I tried the whole gammut of SSRIs; I am sensitive to meds so that's why prozac was the best fit. But I think my body got used to it and its effectiveness wore off.

the mind is such a powerful, crippling organ.

[Focusedmind in reply to Cleo1011]

I thought when you do those tests, they usually give you a range of drugs that you are compatible with. Some medications are similar to Prozac, like Lexapro so you might try similar SSRI drugs. And yes, the mind can be a powerful, crippling organ.

[Agamemnon2022]

I too have treatment resistant depression. I have tried dozens of meds none of which worked. It was always, "Hey have you tried this one." Wait weeks for them to "kick in." They'd work for a week or two then nothing. Sometimes the side effects were worse than the "cure." I finally had to come to terms that medication was never going to cure me. So I had to develop other strategies to deal with my brain and its incessant barrage of negative thoughts. I began exercising on a regular basis; walking. Making sure I get enough exercise; working out with weights and swimming. Developing a wider range of hobbies. Trying to recognize moments in my day to encourage others. Spending time with and being more involved in my family members lives. Trying to have a relationship.

Some days it's so exhausting but on other days I hardly notice it. I go to therapy once a week. But I am 100% off of meds for the first time in decades and I feel better. Am I cured? No. I never will be but I'm somehow ok with that now.

I still get lonely. I still wish I was loved and accepted by someone outside of my family. But I have a small bit of hope and am trying to feed that hope.

I don't know if this helps.

[Cleo1011 in reply to Agamemnon2022]

Hi, thanks for replying. Yeah, I feel that way too. that meds don't work. Really, I look to meds as a "quick fix - solve my problem for me" excuse. Good for you that you get out and have hobbies. I don't have any human interaction other than work, and the obligatory visit to see my parents.

I tried exercising - i hired a trainer b/c I couldn't find the motivation. I stopped after 3 months b/c it wasn't helping my mood, and it was just another "obligation" that I couldn't handle. It really is a struggle to just get thru the day without losing it or breaking down.

Where do you think your depression started?

[Agamemnon2022 in reply to Cleo1011]

I've always had it since childhood but it wasn't diagnosed until college.

[Marysblue]

Hi Cleo..welcome.

[Hidden]

Do you think the Spravato is helping you??? I have been on all kinds of meds for depression and there isn’t too much more for me to try. Recently a new psychiatrist I started seeing recommended Spravato or ECT. Please let me know if you think you’re improving. I heard you have to go to a clinic where they watch you take it and you can’t drive yourself home. Is it just a temporary high you get from it or does it last for days or weeks? I’m nervous about trying it.

[Cleo1011 in reply to Hidden]

Hi, glad you're asking about Spravato. So, the logistics, is that you have to be under supervision for 2hrs during the dosage. They monitor your blood pressure 3x during, and make sure you're not "operating heavy machinery" while under the influence. So yes, you cannot drive yourself home. You're too "groggy" to be driving. The "induction" period is 4 weeks, 2x per week = 8 dosings. Then after the 8th dose, you can taper down to 1x per week, or something. The data shows that to maintain the effectiveness of Spravato, you need to continue on it. its not a "temporary" drug. The typical dose per visit is 56 - 84 mg.

For me personally, I had to work my way up to 56 mg; it was way way way too strong initially. (It could be b/c i'm under 100 pounds). It is a temporary "high" in that it does wear off within 3ish hours and you feel "normal" again. Some people get nauseous from it; I did only on the 1st visit when I discovered 56mg was too much. If you don't eat 2 hrs prior, and take Oandastron beforehand, you should not experience nausea. Spravato can cause headaches; I did have mild headaches here and there. Taking the dose sucks. It is really bitter and I have to suck on jolly ranchers to ease the awful taste.

As for the efficacy, maybe its helped. I am definitely not walking with a bounce in my step and having positive thoughts. but I'm not having frequent suicidal thoughts and crying all day. A side effect I just noticed is that I've become forgetful - forgetting to lock doors, leaving things behind, not remembering a task I did 3 min ago....because of this, I'm going to take a break from the Spravato.

I'm really glad I tried it, b/c now I know. I was intrigued about the science saying Ketamine targets the gamma and glutamate neurons, not serotonin like the SSRIs.

I have not considered ECT - I think that is way too invasive for my liking. ECT I believe they put you under anethesia b/c its inducing a seizure to your brain?? And I read you feel slower and "less sharp".

Let me know if you do try it; I'm curious to hear others' experiences.

[repeatingrepeating]

That pretending always sucks. And then when you aren't faking, people become uncomfortable being near a depressed person.

I've tried countless meds and years of therapy along with TMS. If this current med doesn't work within three weeks I'm trying to decide whether to try Auvelity, an MAOI, Spravato, or ECT next.